• Jennifer L Glick, Katherine P Theall, Katherine M Andrinopoulos, and Carl Kendall.
• Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine , New Orleans, Louisiana.
• LGBT Health. 2018 Apr 1; 5 (3): 171-179.

PurposeThis study examines the associations between discrimination experiences (types and locations) and care postponement among trans-feminine individuals in the United States.MethodsThis secondary, cross-sectional study utilized a subset of the data from the National Transgender Discrimination Survey (n = 2248), specifically for trans-feminine individuals. In this analysis, we examined the relationship between discrimination and primary care postponement.ResultsTwenty-six percent (26.25%) of the study sample reported delaying preventive care due to fear of discrimination; 23.98%-46.66% of respondents reported past experiences of discrimination (setting dependent). Discrimination in health and non-health settings and different types of discrimination-being denied services, verbally harassed, or physically assaulted-were all significantly associated with delaying care; respondents reporting discrimination were up to 20 times more likely to postpone care. While discrimination at a health location had the strongest association with care postponement (adjusted odds ratio = 9.65, confidence interval = 7.60-12.24), discrimination in all non-health-related locations was also important. Individuals reporting discrimination in greater numbers of locations and multiple types of discrimination were more likely to postpone care.ConclusionTo promote preventive care-seeking, these results affirm the importance of interventions that promote discrimination-free environments for gender minorities.

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